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Influence of Renal Impairment on the Success of Reconstruction Using Microvascular Grafts—A Retrospective Study of 251 Free Flaps

Background: In head and neck surgery, reconstruction using microvascular grafts is a successful method for functional and aesthetic restoration. Due to technological advances and medical care, the number of patients with comorbidities and diseases requiring free tissue transfer has increased. To pro...

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Autores principales: Moellmann, Henriette L., Karnatz, Nadia, Degirmenci, Ilkan, Gyurova, Antonina, Sellin, Lorenz, Rana, Majeed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604965/
https://www.ncbi.nlm.nih.gov/pubmed/36294883
http://dx.doi.org/10.3390/jpm12101744
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author Moellmann, Henriette L.
Karnatz, Nadia
Degirmenci, Ilkan
Gyurova, Antonina
Sellin, Lorenz
Rana, Majeed
author_facet Moellmann, Henriette L.
Karnatz, Nadia
Degirmenci, Ilkan
Gyurova, Antonina
Sellin, Lorenz
Rana, Majeed
author_sort Moellmann, Henriette L.
collection PubMed
description Background: In head and neck surgery, reconstruction using microvascular grafts is a successful method for functional and aesthetic restoration. Due to technological advances and medical care, the number of patients with comorbidities and diseases requiring free tissue transfer has increased. To provide adequate treatment to these patients, preoperative identification of potential risk factors is essential. Methods: In this retrospective study, we investigated the impact of renal insufficiency on reconstruction in 251 microvascular grafts. Perioperative complications, failure rate, and outcomes serve as the basis for this evaluation. Results: Comparing pre- and postoperative values, there was a significant decrease in potassium and creatinine levels and a significant increase in GFR. The electrolyte changes in relation to the complication rate showed that complications were more likely to occur as potassium levels increased. As sodium levels increase, the complication rate decreases. Conclusion: A preoperative value indicative of impaired renal function, such as creatinine levels, GFR, or electrolytes, did not prove to be an individual risk factor for the occurrence of graft failure in this patient population. Nevertheless, increased renal parameters are associated with increased incidence of serious complications. Therefore, these should be considered in the indication and preoperative planning.
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spelling pubmed-96049652022-10-27 Influence of Renal Impairment on the Success of Reconstruction Using Microvascular Grafts—A Retrospective Study of 251 Free Flaps Moellmann, Henriette L. Karnatz, Nadia Degirmenci, Ilkan Gyurova, Antonina Sellin, Lorenz Rana, Majeed J Pers Med Article Background: In head and neck surgery, reconstruction using microvascular grafts is a successful method for functional and aesthetic restoration. Due to technological advances and medical care, the number of patients with comorbidities and diseases requiring free tissue transfer has increased. To provide adequate treatment to these patients, preoperative identification of potential risk factors is essential. Methods: In this retrospective study, we investigated the impact of renal insufficiency on reconstruction in 251 microvascular grafts. Perioperative complications, failure rate, and outcomes serve as the basis for this evaluation. Results: Comparing pre- and postoperative values, there was a significant decrease in potassium and creatinine levels and a significant increase in GFR. The electrolyte changes in relation to the complication rate showed that complications were more likely to occur as potassium levels increased. As sodium levels increase, the complication rate decreases. Conclusion: A preoperative value indicative of impaired renal function, such as creatinine levels, GFR, or electrolytes, did not prove to be an individual risk factor for the occurrence of graft failure in this patient population. Nevertheless, increased renal parameters are associated with increased incidence of serious complications. Therefore, these should be considered in the indication and preoperative planning. MDPI 2022-10-20 /pmc/articles/PMC9604965/ /pubmed/36294883 http://dx.doi.org/10.3390/jpm12101744 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Moellmann, Henriette L.
Karnatz, Nadia
Degirmenci, Ilkan
Gyurova, Antonina
Sellin, Lorenz
Rana, Majeed
Influence of Renal Impairment on the Success of Reconstruction Using Microvascular Grafts—A Retrospective Study of 251 Free Flaps
title Influence of Renal Impairment on the Success of Reconstruction Using Microvascular Grafts—A Retrospective Study of 251 Free Flaps
title_full Influence of Renal Impairment on the Success of Reconstruction Using Microvascular Grafts—A Retrospective Study of 251 Free Flaps
title_fullStr Influence of Renal Impairment on the Success of Reconstruction Using Microvascular Grafts—A Retrospective Study of 251 Free Flaps
title_full_unstemmed Influence of Renal Impairment on the Success of Reconstruction Using Microvascular Grafts—A Retrospective Study of 251 Free Flaps
title_short Influence of Renal Impairment on the Success of Reconstruction Using Microvascular Grafts—A Retrospective Study of 251 Free Flaps
title_sort influence of renal impairment on the success of reconstruction using microvascular grafts—a retrospective study of 251 free flaps
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604965/
https://www.ncbi.nlm.nih.gov/pubmed/36294883
http://dx.doi.org/10.3390/jpm12101744
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